| NPI | 1508863176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036058383) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IA 23454) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2015-02-05 |